SINCE pheochromocytoma has been widely recognized clinically as a cause of hypertension, many unusual aspects of this tumor and the clinical syndrome it produces have been reported. These have included errors in diagnosis, false negative and false positive pharmacologic tests, and extra-adrenal location of the tumor.* The case to follow illustrates another unusual aspect of the clinical syndrome, the requirement of massive doses of arterenol ( Nor-epinephrine) following surgical removal of pheochromocytoma. The management of patients with pheochromocytoma before, during, and after surgery has recently been reviewed by Sprague and others,4 and the usual methods of vasopressor maintenance will not be reviewed here. The following case illustrates the failure to maintain a normal postoperative blood pressure until massive doses of arterenol were used.
The patient was an 11-year-old white boy first seen in September, 1954, because of weight loss, easy fatigability, lassitude, and night sweats of approximately three months' duration.